Oral and particularly dental care involves performance of various procedures, such as removal of biofilm or plaque, removal of discolorations and dental calculus, dental filling procedures and the like, that can be carried out by a dentist assisted by a dental assistant or by a dentist, a dental assistant or an oral hygienist individually.
An oral hygienist's job description entails, among other things, providing oral health examination, cariological screening, regional treatment programs and implementation of treatment as well as opinions within his or her area of responsibility. An oral hygienist notices mucosal changes in a patient, examines the patient's occlusion and, when necessary, refers him or her to a dentist. In addition, the oral hygienist is an expert in the factors associated with the origin, progress and treatment of periodontal diseases.
When oral care is carried out as teamwork, i.e. when a dentist performs the actual treatment procedures, an assisting person performs the rest of the related procedures. Such procedures include e.g. removal of saliva and washing-off liquids, polish and filling residues as well as blood and medical substances out of the patient's mouth. This enables the dentist to freely concentrate on his or her own work.
Often, however, oral and dental care procedures are carried out by one person working alone, in which case the person's musculoskeletal system is subjected to strain in different work postures. When working alone, it is impossible e.g. for an oral hygienist to always maintain the best possible ergonomic work posture but sometimes he or she has to work in non-ergonomic postures. In oral health care, the confined space of the working area inside the mouth and the design of instruments often compel a hand into positions wherein the generation of force is harmful to the joints, muscles and tendons. The work of an oral hygienist thus comprises several risk factors that may cause musculoskeletal diseases, in the area of the upper limbs and the back as well as in the neck and shoulder area in particular.
The clinical work of an oral hygienist thus involves a lot of manual work and requires special accuracy. In accordance with prior art, the work includes applying a lot of compressive force by the fingers when operating with different instruments. The task of directing instruments and the accurate working require stiffening of the joints of an upper limb as well as maintenance of both the gaze and the posture of the head by means of the muscles in the neck and shoulder area.
According to a publication entitled “Suuhygienisteillä ilmenevät tuki- ja liikuntaelimistön terveysongelmat sekä niiden ennaltaehkäisy” by Laura Heikkilä and Hanne Ilvonen, the most common diseases caused by stress on the upper limbs are tenosynovitis, epicondylitis of the humerus and carpal tunnel syndrome. Work-related risk factors increasing a person's chances of developing tenosynovitis are the high recurrence of work movements, use of strong compressive manual force, and bent positions of the wrist. In addition to those mentioned above, the risk factors for epicondylitis of the humerus include power-demanding flexion-extension movements of the wrist and the fingers as well as rotational movements of the forearm. The risk factors for carpal tunnel syndrome are the same as those for tenosynovitis and epicondylitis of the humerus. A tweezer grip of the hand and use of vibrating instruments are also risk factors for the aforementioned stress-related diseases. In addition, the oral hygienist performs the dental care procedures in a sitting position in which the recurrent uplifted positions of the upper limbs, reaching out and extreme rotational movements impose stress on the muscles of the shoulders and upper arms and in which controlling the dimensions and use of force is difficult.
The aforementioned procedures for removing different materials from the patient's mouth are almost invariably carried out by means of a vacuum-operated suction system. Generally, a dental care unit is provided with high volume evacuation operating at a greater underpressure and suction which operates at a lower underpressure and which often refers to a device for saliva suction to be hung from the patient's lower jaw; such devices may come in different shapes and are designed for removing saliva collected in the mouth e.g. during a filling procedure and often for simultaneously keeping the tongue out of the working area.
When another person is in charge of the high volume evacuation, the work runs smoothly, both of the dental workers knowing their own tasks. However, it is quite often the case that only one dental worker is present, which naturally means that all procedures then fall into his or her responsibility.
While working alone, the liquid removal from the patient's mouth is particularly problematic and laborious. Procedures wherein a lot of water collects in the mouth require the use of high volume evacuation and a high volume evacuation tip associated therewith. The high volume evacuation tip is designed for the conventional teamwork between a dentist and a dental assistant. The dental assistant is responsible for removing liquid by the high volume evacuation tip, enabling the dentist to concentrate on the clinical procedure. As the oral hygienist's job description expands, the number of clinical procedures demanding accuracy has increased also in the work of a dental assistant and oral hygienist: a need exists for a more accurate removal of liquid and other materials that is less tissue-damaging than the current suction tip solutions, as well as for more ergonomic working.
WO 2005/107832 A1 describes a hand mounted surgical aspiration device. According to the publication, the suction tip to be attached to a finger provides a surgeon with a better view of the operative field when no assistant interferes with the surgeon's field of vision. However, in order to direct the suction at the operative field according to a first embodiment of the publication, the suction has to be squeezed between the fingers. In the sheath-like solution of a second embodiment of the publication, a suction tube is shorter than a finger, in which case the finger interferes with the suction and the use of the suction is inaccurate. Further, the sheath completely covers the distal interphalangeal joint of the finger while the distal interphalangeal joint resides inside the sheath. In such a case, when the finger is bent, the sheath imposes pressure on the distal interphalangeal joint which is subjected to pressure and resistance by the sheath, and the joint is subjected to stress.
SE 468237 describes a device for removing saliva by means of suction. A problem with the publication is, however, that in practice a finger clamp attached to the metacarpophalangeal joint of a finger leaves the end of the suction tube hanging, thus making the suction impossible to be directed accurately to the target area.